Q&A: Allowing for Diet and Exercise Changes During Pregnancy

I had an endurance planet question come in from a fellow preggo mama-to-be that really stuck with me, and I wanted to share the question and my written response. I normally never write replies to our fan's questions (that'd be a full-time job), and we just answer as many as we can on the podcast. But this Q was a bit different than any I've ever had before and I wanted to get back to her because, for one, her's is a situation where every day counts, and secondly, this topic is forefront on my mind and super relevant to my current theme of life too, hence why I'm sharing on the ol' blog...


R: "A followup... I didn't end up qualifying for Boston, because I found out a few weeks before the marathon that I was pregnant.  Now, I have a question for you about eating/training during pregnancy.

I am still in my first trimester (about 10 weeks), and I am having a hard time eating anything other than carbs (fruit, oatmeal, sprouted grain English muffins, Chex Mix and popcorn :0(. The thought of meat or vegetables is absolutely the most disgusting thing to me right now, and I feel pretty nauseous (but strangely starving) most of the time.  Over the past few years, I had reduced the amount of carbs I was eating to about 100 - 150 g a day (not super low, but lower than I used to eat), and noticed I felt much better and no longer got "hangry."  I know pregnancy increases your insulin resistance, so I am worried about getting carb-addicted again, or worse, getting gestational diabetes.  At the same time, though, I am also worried that I am undereating.  I think I have been averaging about 1600 calories a day while still running around 40 miles a week and lifting 3 times a week.  I'm 5'4 and about 113 pounds.

My question is - is it better to eat more (even if it is mostly carbs) or should I cut back on running until I can get back to a more balanced diet? I obviously want my baby to get the nutrients he or she needs, but I have had an eating disorder in the past so feeling out of control of my body and not being able to eat normally is bringing up a lot of mental demons." 


TPG: Thanks for reaching out on this, and congrats on your pregnancy!!! It sounds like you took a very sensible approach to the marathon, assuming you still ran, and that's great.

Ok.... (warning: a novel is about to ensue....)

Diet

Honestly, don't worry about the increased carb cravings. This exact thing happened to me in the first trimester (and is still happening at 30 weeks) and I just rolled with it, giving my body what it wants even if that's not my typical pre-pregnancy type of meal or snack. Your body is telling you something with these cravings and you have to listen; I say this with the best intentions: Don't let your brain get in the way ;) Trust your body -- and I know that can be hard with your background, but you're going to be a mama and I know you can do it!!!

When I asked my midwives & ND about my increased carb intake, they reassured me that a baby requires A LOT of glycogen to develop and properly grow, so it's up to us moms to supply baby with that, along with healthy fats and proteins -- all the macros are important here!! Protein needs are 80-100 grams a day. Fat is crucial in so many ways, including building a healthy brain. And obviously you're still making mostly all smart quality carb choices (with a some indulgences too, and I think that's ok; did I mention I've had several donuts while pregnant and usually have a GF dessert on hand at any given time?! LOL).

With my increased carbs (and even sugar), I definitely wondered if I was risking GD, but I just had my test two weeks ago and my results were phenomenal, which impressed me that even with essentially a much higher carb diet, my blood sugar regulation is still awesome, and I'm sure you'll be the same way from what it seems. So I say eat your carbs freely and without worry.... you clearly still know how to make smart food choices overall and aren't on a junk diet.

If it's hard to get in veggies and meats, look to smoothies, protein powders/collagen peptides and green juices to help you out. I drank a ton of green juices in the beginning to get in the greens/veggies I wasn't consuming otherwise. And now big-ass smoothies with greens, veggies, fruits and protein powders, (real) milk and sometimes even peanut butter are a staple for me to get in dense nutrients without wanting to gag when everything else sounds nasty ;) Plus, the aversions usually subside in the 2nd trimester too, and you'll enjoy meat and veggies again (I did). But there are still those days, and I'm sure there will be for you, where all you want are carb-based foods and no meats or veggies. In those cases, I just try to keep an overall smart balance and not worry about one meal -- it's the overall big picture that matters. 

I've actually been very liberal with my food intake during pregnancy, eating a huge variety of foods (more so than pre-pregnancy) and not stressing the small stuff (like if we eat out I know I can't control all the ingredients), meanwhile just making sure that overall there's a good foundation of healthy eating. For example, I also have struggled with eating fish (something I usually can't get enough of), but I know how healthy those fats are, so thankfully I found out that if I bake wild salmon in teriyaki sauce then it's delicious, and even though there's sugar and soy in the teriyaki, it's better than no fish or "gross plain fish" in my opinion! And for nearly 30 weeks now, I've pretty much hated salad, something I used to eat daily, so I'm just finding replacements and not worrying about it.

Get in a good prenatal that has FOLATE not folic acid; I use Thorne's prenatal. And fish oil (Nordic Naturals is my choice). Probably a good probiotic (I've been using Sound and Prescript Assist), and any other supplement you and your doc/midwife deem necessary. 

Exercise

As for the running, it's my personal philosophy that pregnancy is a time to let go of your training and athleticism, and just put all your energy into building a healthy baby. That doesn't mean being inactive, but it means modifying your routine if you're an athlete. Right now you're training for something completely different.

I know everyone is different, but personally I think 40 mpw running is too much. That's just my opinion. Gwen Jorgenson was still running 70 mpw at some point in her pregnancy, but we don't all need to strive to be a Gwen. That was ok for her, she seems smart and I'm sure was working with her doctors on that, but just because she ran that much doesn't mean it raises the bar for the rest of us preggo ladies -- or that we're inadequate if we have to cut back and can't run all the miles. There's no shame in doing less.

I haven't run more than ~10-15 mpw since becoming pregnant, I had a 8-week break sandwiched in while letting the SCH heal, and after my 27th week I quit running because it was getting too uncomfortable and not feeling worth it. I'm walking a lot more instead these days (~10-15 miles a week walking, or about 2 miles a day at least), and usually 2x a week of relatively light strength training. That's it. It's not training mode whatsoever, but it is doing healthy activity that'll be best for my baby's health and mine.

Please don't feel like you need to "do it all," maintain some level fitness and keep a lean physique -- you need to gain healthy weight and let your body grow how it needs to support the baby!!! At 30 weeks, I weigh 165 lbs +/- right now.... that's 30+ more lbs than my wedding last year, and quite frankly I love my body more than ever right now and embrace the changes daily. Allow for the weight gain to start now in the first trimester even if all the articles say otherwise. Many articles/books will say that you shouldn't or don't need to gain weight in the first trimester, but that's general advice for the general population and you're not general, you're you :) I gained 8-10 lbs in my first trimester lol.

Pregnancy, from what I'm learning, is also so much about relaxation and not just for the 40ish weeks, but for the birth day and after. If you want to have a successful vaginal birth, it seems pretty clear from what I've been reading and learning in my class that being relaxed is the No. 1 way to achieve that. So practicing your relaxation -- mind and body -- starts now. You don't have to be perfect (god knows I haven't thus far) but just recognizing it and practicing is key!

That said, just being honest here, there will probably be a lot of little things that worry you along the way because this is all so new... but work through each of them, find peace and the ability to relax, and let it go, assuming everything is ok. Talk to your doctor/midwife, communicate with your partner/friends/family, and don't bottle it up. By even simply writing me this question, that's a big successful step in what I'm talking about! So I know you can do it.

It sounds like you successfully beat an ED, big congrats on that as well, and this chapter of your life should only serve to make you more confident in your own skin. When the mental demons arise, understand that you have the power to counteract them with positivity, smart logic and the same powers that got you through an ED, and if you still struggle, make sure you have a great team on your side who can help you through those moments.

So overall, I think you should both eat more and workout less, and find comfort that this is in your baby's best interest even it if feels weird to you personally.

Lastly, guess what: Pregnancy is just the beginning... after this we will have babies that need our full attention and love to thrive (and still eating good, dense calories if you plan to breastfeed). We'll worry, but we can't live in a state of worry. Whether you have a girl or a boy, you want to be a strong confident mom who's giving her baby the best vibes ever so he/she can grow up being strong and confident as well :)
Hope this helps. 

BEST OF LUCK TO YOU XOXOOXOOXOXOXOOOO

First Trimester Thoughts - Rolling With the Changes!

I'm 12 weeks pregnant today, which means my first trimester is winding down (already?!). All in all, preggo life has been a rather easy adjustment for me. You don't have a choice over your body feeling so different, it often acting crazy nor your new set of "rules" by which to live, but you do have a choice in your attitude, response and general mood. You can freak out and worry or just roll with it and enjoy this special time. I had one freak-out episode in the beginning and learned my lesson very quickly. Since then I've been rolling with it... every single little thing. I really have never felt so relaxed for a three-month period in recent memory.

New norm - double-fisting water while everyone else drinks cocktails.

Here are some thoughts and highlights from my first trimester:

Diet - Pre-Conception & To 6 Weeks

Turns out leading into my pregnancy, I was actually in a mild state of ketosis (not my first time), thus very likely in ketosis when I conceived (unless all those desserts and drinks I had at the wedding we attended the weekend it happened threw me out of keto lol). I was not trying to be keto whatsoever, but as I said in the this post, I had rather intuitively transitioned back to lower carb around late April and that combined with the other things I did, I was quickly feeling awesome, physically and mentally. Pretty certain I was still eating more than 70 grams of carb, if note more than 100 grams on some days, but apparently I was low enough to be pushing out ketones as confirmed on a pee test. The thing is, and why I think it worked out, is that my daily calories were consistency high, I was eating very nutrient-dense foods, and my "training" was moderate -- not too intense and about 7-10 hours a week including walking. So apparently this is one example of when ketosis/low carb can work out without negative ramifications when it comes to hormones, fertility and even stress management.

In fact, when I told this to Dr. Phil Maffetone, he said low carb/ketosis can work great for fertility and is safe for pregnancy. I'm not so sure that I agree with that across the board nor should we force anything that doesn't feel right, but given my own situation I'm less of a skeptic. I asked a very accomplished pro triathlete friend of mine, who's also currently pregnant, if she was still in ketosis when she conceived and if she's remained low carb. I know this diet approach worked wonders for her (she's one of the few), and it turns out she has stayed low carb all throughout her pregnancy so far (she's almost 3rd trimester), and she was keto when she conceived as well. She says she's had the easiest pregnancy, no cravings, no aversions, no nausea, able to workout but not "train." Wow. Must be nice, right?

All this doesn't mean I'm advocating ketosis for fertility, pregnancy or otherwise, I still think it's a very individual decision to go low carb and in many cases it can be playing with fire. Plus, on the flip side there are plenty of gals who've gone higher carb/higher calorie and not only fixed their fertility but got pregnant this way, just look at the evidence presented by Nicola Rinaldi in No Period Now What. Plus carbs are not the reason one would get more nauseous or sick despite what some may say; plenty of women who are higher carb also have easy pregnancies with little to no morning sickness. So it just depends. Regardless of macro ratios, what does matter, arguably the most, is that you're eating a lot of calories and not being underfed. I know that's Amanda, I know that's me, and I also know that's my friend Tina Muir who overcame amenorrhea and got pregnant right away (we talked about it on her podcast, which you can hear here).

Btw, a huge shoutout to Tina for her massive lifestyle changes that helped her overcome amenorrhea and achieve her next dream of becoming a mama. She hired me as a consultant in 2016, and we talked a lot about this stuff. I knew she'd pull the trigger when she was ready, and I'd like to think I had a tiny influence on her journey and where's she's at now. I couldn't be happier for her :)

Anyway, once I found out I was pregnant at 4 weeks, I didn't try to maintain or force low carb by any means, I just ate what I felt like, but little did I know things were really about to change...

Diet - From 6 Weeks On...

As soon as I hit six weeks my diet changed drastically! All of a sudden my carb cravings were literally THROUGH THE ROOF. Unlike anything I'd experienced before and I was dreaming of pizza, ice cream, waffles, granola, bread, you name it. Meanwhile my food aversions hit me like a ton of bricks. I went from loving sunny-side-up eggs, avocado, all the veggies and salad to being grossed out by all of that for the most part. I could eat veggies but only if they were hidden in a dish with other things like sauces and carbs (i.e. curry with rice... with some veggies tucked in), or pureed veggies in a creamy soup. To make sure I was getting daily greens I started drinking a lot of organic green juices.

I have not had consistent cravings; it seems like each week (sometimes each day) my body is asking for something else. I was digging granola and yogurt in the beginning and now it makes me want to puke. I was ALL about dairy for several weeks, like I NEEDED it, and now I can take it or leave it. I'll enjoy high-fat smoothie bowls for breakfast on some weeks and other weeks they make me wanna gag.

Overall I'd say I'm still eating really healthy, mostly organic (except if we eat out and I have no choice), and I'm avoiding shitty ingredients from junk foods. Personally, though, I feel like I'm eating crappier simply in the sense that the increase in carby and sugary foods are often replacing my usual greens, veggies and in many cases fats or animal proteins, but it's not like what I'm doing is unhealthy by any means, it's just different than my normal standards. Also on the eating out thing, my motivation to cook hit an all-time low and we've been eating out more than usual, like 2-3 times a week, so I'm sure I've been served vegetable oils and conventional meats and produce, but what can you do. I'm not trying to control everything and I need to just do what's best for me right now so if I don't wanna cook I won't (PS - John is busier lately, and picking up a lot of my slack, so I don't except him to slave over the kitchen too). I do my best to get in quality animal protein in most my meals, but there are times when I simply don't want meat and/or I'm incredibly picky about what meat I'll be able to eat. There's not rhyme or reason and it's always changing. One night I will looooove salmon, one night I just can't do it.

My favorite random cravings have included lobster bisque (WTF is that about), seaweed salads (iodine), sauerkraut (probiotics), pad thai, curry, waffles but NOT pancakes, pumkin pie (have yet to have any) and an old throwback to a childhood comfort food: egg sandwiches with strawberry jelly, mayo and butter. Yes you read that correctly, jelly and mayo together with egg on toasted bread with butter. You can ask my grandma about how that one came to be. I'm using sugar-free jelly (just the sugars from fruit), Primal Kitchens Mayo, Kerrygold Butter, pastured farm-fresh eggs and a gluten-free paleo bread from the farmer's market, so actually pretty darn healthy!

The days I feel most nauseous carbs are the name of the game, and often some interesting choices...

This was a real DINNER - three or four GF waffles and Halo Top ice cream, with tea. Word.
John had leftover chicken with his waffles lol!

I've also craved a lot of "normal-people food" like pizza (keeping it GF), ice cream, burgers, all the fruit, tortilla chips (not the healthy kind), rice bowls, "healthy" rice crispies cereal. I've had pizza (aiming for healthy organic ingredients) at least 8 times so far, more than I've eaten in the past three years likely!

By week 10 I felt like was feeling a lot better most days and wanting to eat more of my usual foods -- back to salads, avocados, and lots of veggies -- but usually still piling on more hearty carb choices. It's not that paleo.

One night I got my act together and made homemade green curry!
I ended up eating about 3x more rice than what's shown.

This was a good dinner.

Exercise

I'm so glad I love to exercise and that I started out my pregnancy out with a decent base -- not necessarily "fit fit" but very adapted to daily exercise. But weeks 5-8 I didn't do a whole lot of exercising at all (minimums like 30min/day, and lots of walking). At first it was likely because deep down I was a bit afraid to "over" exercise and risk anything. I got over that. Then it turned into minimum exercise because I wasn't feeling too hot. At the very least, I'd get out and walk every day with Finley, if not a couple to three times a day.

My nausea could come any time of day or night, but it would usually set in after breakfast before lunch so if I got moving around that time it helped. However some days exercise was not the answer and I needed a nap instead, so I'd go crawl back into bed and not even think twice about it. I've been incredibly proud of my flexibility and intuitive nature. I'm not letting anything bother me -- food choices, exercise choices, whatever -- and just rolling with it. If I take a nap before lunch, so be it. If I take a two-hour nap at 3 p.m., so be it.

I started feeling better and better, thankfully. At this point, I'm running about three times a week on average, between 3-5 miles, probably all at a 9:00-12:00 pace depending on heat and terrain. I'm not wearing a HR monitor but I am keeping my effort in check, i.e. aerobic, and not doing anything that feels too aggressive. I'll always walk if HR feels like it's getting a bit too high or there's a steep hill (and I end up walking at least some portion of every run I do). Some days I feel like a rockstar other days I feel like I'm carrying a ton of bricks.

I'm also strength training at home about 2-3 times a week, easy sessions of 15-30 minutes that include kettlebells, TRX, and bodyweight exercises. I'll usually round out these sessions with some mobility and yoga poses.

I have eased back on paddleboarding since my race, but started swimming again in July, and, oh man, for the first time in a long time I'm really enjoying the pool. So refreshing and especially a nice way to get moving and not overheat during this HOT summer. Since my form still sucks, I have to be careful to not let my HR soar due to inefficiency; I'm mostly doing sets of 50s and 100s -- and that's currently "endurance" ;)

Then there's lots and lots of walking, thanks to Finley! A lot of athletes talk shit on walking, and I can understand why, but I think they're wrong. Just sayin. I love it, I find it so beneficial -- mentally and physically -- whether in training or not. Science supports me ;) I've been taking short walks after meals, especially dinner, to aid in digestion, and that helps too.

Tonight I'm going to my first prenatal yoga class and excited to learn some new moves, and I hope to keep up with that.

I'm also getting massages, albeit much LESS frequently than when in training mode. But with the swimming and strength, I build tension and massages help. Thankfully my gal who I've been seeing forever is certified in pregnancy massage.

Energy

My energy (and fatigue) = a rollercoaster. I never know what to expect next; some days I feel so great that I wouldn't even know I'm pregnant and other days I'm so dead that I barely leave the house and take multiple naps. Thankfully overall I've had way more good days than bad, and on average I feel pretty decent, not normal, but decent.

I quit coffee the day I found out and that was a tough transition from a fatigue standpoint. I didn't get headaches or anything but I was wasted tired for like three days before coming out of the fog. Then I felt ok not having coffee but was still often slow to get moving and often finding it hard to focus and get shit done. I don't blame the lack of coffee for that, I blame the hormones and all the changes in my body!

I met with my naturopath during week 8, and she said it'd be totally fine for me to have a tiny bit of coffee each day, just don't exceed 200 mg/day (which is actually quite a bit so it's pretty easy to stay under that). Around week 9 I started drinking a shot of regular homemade cold brew per day, which I further diluted in water -- about 1 part coffee, 3 parts water. I'll sip on that after breakfast only (never on an empty stomach) and usually won't even finish all of it. But even having that tiny amount has been so nice and it does help me.

My work productivity has really suffered the past two months, and of all things going on as of late this is the one thing that's caused me a bit of stress. I don't like feeling like I'm not being productive or contributing to our family. I mean, I'm still working -- I have all my coaching clients (thus writing workouts, frequent communication with them, guiding health plans, etc.), doing some consults, writing for and managing my inner-circle lifepostcollective.com, etc. I took the break from the podcast, which was probably a great call, but I'm ready to go back to it and will return later this month. WOOT!

My original plan during this summer, even before pregnancy, was to get busy writing my first book. I've done a fair amount of prep, outlining and even wrote the first chapter, but I am nowhere near where I'd like to be by now, and I feel very guilty about that. Since it's on my shoulders and no deadlines, it's been easy to procrastinate... or go nap or scroll through social media instead when brain cells feel dead. Ugh.

Everyone says just be kind to myself and don't put too much pressure on myself during this time (especially the first trimester!!!). For the most part I've been living up to that (obviously I'm letting myself relax, take naps, chill, etc., rather than busting my balls) but I'm normally a go-getter and it's just weird to be so low-key and not living up to my usual productivity. I'm sure once baby is here it'll get even more chaotic for a while. Thank god I have a supportive hubby who always says, "don't worry about it" when it comes to work and stuff.

Meanwhile, we've been getting out a lot and not being hermits whatsoever. Parties, concerts, dinner dates, whatever... I'm not in the mood to just sit around and I can always find energy for a good social outing or live music. This weekend we're seeing Jack Johnson, hell yea.

My Body

I was already at a very healthy weight/normal BMI when I conceived, 142 lbs, which was up from my average weight of 135 in recent years, but apparently my body wanted even more "cushion" because I went through an initial surge of putting on another 5-6 pounds right away in those beginning weeks (averaging about 1 lb gain a week)... my naturopath and midwife said that's totally fine and normal (despite books saying that NO weight gain is often normal in the first trimester). No doubt my diet played a role, but I was just listening to my body's needs. Since then, the weight gain has tapered off to where recently I'm not even gaining a pound a week. Right now (at 12 weeks) I'm holding steady at 148 lbs... but by the end of each day I'm probably more with the bloating I usually get.

I feel really strong, in fact I feel like all that muscle under my fat has hypertrophied a tad (getting swole for baby!), but I also just feel so big already. I'm certainly NOT one of those petite pregnant ladies who barely gain any fat and who don't show until week 28 or something. Ha, anything but! Whether it's a food baby, bloating or the real baby, I certainly have a tummy bulge already and certainly have more fat everywhere... And I'm proud of it! No bump-only pregnancies over here.

Most my clothes still fit, although certain clothes I'm not even bothering with, and I have yet to try on my jeans (it's too hot anyway so why bother). While it's most comfortable to wear my baggiest clothes, I also don't shy away from a tighter stuff. I'll still run around in 2-piece swimsuits and wear tight workout tops or booty shorts (booty shorts = my shorts that used to be loose and baggy lol). I live in my lululemon run shorts (stretchy!) and sports bras over real bras all the way. Speaking of, I had to buy some new sports bras (all mine were size small) as I was getting smashed and it was starting to hurt. Some of my swimsuits fit, whereas some make it hard to believe I actually looked good in them at some point (hello muffin top). I will say, it's very nice to have bigger boobs, that I am enjoying ;)

I'm the type of person who gains weight all over, and that's holding true during this pregnancy so far, so I don't look too fat in any one area, just like a larger bigger-boned version of me. No shame, and I'm not trying to hide a thing. This is pregnancy, you're not supposed to remain rail thin!!!!!!

I know my mom was ginormous with my sister and I, so I expect that'll be me too. At some point, I'm sure I'll weigh more than John, and I'll proudly flaunt it.

12 week "bump" shot!

Anyway, that's my story so far. thanks for reading!